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Friends 'key' to helping those with mental illness quit smoking

Friends who are former smokers are key to helping people with serious mental illness quit the habit, according to US researchers.

They noted that people with serious mental illness have a reduced life expectancy of up to 25 years compared to the general population, with smoking one of the primary reasons for this disparity.

“It’s important we investigate these social networks and their impact on our health”

Kelly Aschbrenner

The researchers in New Hampshire explored how social interactions and personal relationships influenced outcomes among those with serious mental illness participating in smoking cessation programmes.

They asked 41 people who were taking part in smoking cessation treatment in community mental health centres to identify their social contacts and their relationships, including whom they spent the most time with during a typical week.

They were also asked to name up to five people who have said or done anything to influence their smoking in the past year.

In total, each person named up 10 friends, family members, roommates, romantic partners, work colleagues or others who they spent the most time with or who had influenced their efforts to quit.

They then were asked to give information on the type and strength of the relationship. For example, whether and how often they had smoked with them in the past 12 months, the smoking status of the contact and if they had ever helped or hindered them with quitting.

The findings revealed that 42% had a psychiatric diagnosis of bipolar disorder, 32% had a diagnosis of major depressive disorder, and 26% had a diagnosis of schizophrenia or schizoaffective disorder.

Participants reported contacts’ smoking status as 52% being current smokers, 30% never smokers and 18% as former smokers.

The study, published in the journal Translational Behavioral Medicine, revealed that 63% of participants had smoked with a contact at least once per month during the past year.

In addition, 57% of contacts had helped a participant quit smoking within the past year, whereas 14% of contacts hindered a participants’ efforts to quit smoking.

According to participant reporting, 90% of contacts approved of them using counselling to quit smoking, while 75% approved of using medications to quit.

The findings indicated that the strongest result was the association between contacts’ smoking status and study participants’ smoking status.

Kelly Aschbrenner

Source: Dartmouth Institute

Kelly Aschbrenner

Having contacts who were former smokers decreased the odds that participant was still a smoker following cessation treatment, said the researchers.

They also found that having a highly connected friend group was associated with decreased odds that the participant was still smoking post-treatment.

The researchers noted that having former smokers in the network may be a valuable resource for quitting, particularly for vulnerable groups where there is a high prevalence and acceptability of smoking.

In addition, they suggested that future cessation treatments could teach smokers with serious mental illness effective skills for seeking support for quitting from people in their social networks.

Lead author Kelly Aschbrenner, assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, said: “The clustering of health behaviors and outcomes, such smoking and obesity, in social networks is well-documented.

“It’s important we investigate these social networks and their impact on our health, so we can design better public health programs and policies, particularly for vulnerable or disadvantaged groups like people with serious mental illness,” she added.

Efforts to boost health professionals’ knowledge of nutrition and ensure they feel confident talking to patients about sensitive topics like weight are among steps designed to tackle the UK’s obesity crisis set out in the long-term plan for the NHS in England.

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